By Dr Laura Corr For The Mail On Sunday
Hunks of bread with bacon, sugar in coffee… cakes, puddings and potatoes served just about any which way. When I was younger, I ate them all without a thought.
Today, though, as a cardiologist with 25 years experience, I see things differently. I still love delicious cheese and salami, and I adore Christmas pudding and brandy butter.
In fact, I’m more passionate about food than ever. But I now know that diet has a direct impact on our heart health, both immediately and far into the future. And these are facts I can’t ignore.
As a doctor who specialises in the heart, I’ve performed hundreds of operations to insert stents into heart arteries, restoring circulation to reduce chest pain and stop heart attacks.
Where it’s needed, I prescribe medication to control cholesterol and blood pressure.
But I feel passionately that we shouldn’t be trying just to fix broken hearts, but to prevent the disease by investing in our arteries all our life. And so the conversation I have with patients that is probably the most life-changing is the one about food.
If they’re able to make the simple changes needed to build a heart-healthy diet, I know that they and their families will be transformed.
Some risk factors, like your genes, age and gender can’t be changed. Others, such as what goes into ready meals, or air pollution, need to be addressed by industry and politicians. But not smoking, daily exercise and eating right, are things we can choose to do, and will make a big difference to heart disease risk.
In fact, recent research from the Journal of the American Medical Association suggested that poor diet could be related to nearly half of all deaths from heart disease, stroke and diabetes. And, thanks to mounting scientific evidence, clear healthy eating principles have emerged.
You will have heard it said before, but it’s a fact that following a Mediterranean-style diet has wide-ranging benefits for the cardiovascular system, helping to curb obesity, diabetes, high blood pressure and high cholesterol.
The research that has proven this is convincing. It includes huge databases of people followed for many years, looking at the relationship between the Mediterranean diet and health, as well as smaller controlled studies asking people to include a few key ingredients – such as fish, nuts, or olive oil – into their everyday diets to see if they made a difference.
My message is about adopting a way of eating that prioritises vegetables, fruits, wholegrains – and yes, hunks of wholegrain bread can be included in this – fish, nuts and olive oils. Many patients are surprised to learn that full-fat dairy milk and yogurt are encouraged, and for most people eating eggs and shellfish too. Both foods, once considered ‘high cholesterol’ are in fact absolutely fine +8
My message is about adopting a way of eating that prioritises vegetables, fruits, wholegrains – and yes, hunks of wholegrain bread can be included in this – fish, nuts and olive oils. Many patients are surprised to learn that full-fat dairy milk and yogurt are encouraged, and for most people eating eggs and shellfish too. Both foods, once considered ‘high cholesterol’ are in fact absolutely fine
In almost every major condition, from diabetes and bowel disease to breast cancer and especially heart health, this way of eating has been found to reap benefits.
I always start by asking patients: ‘What food do you like?’
You see, there is no one food or meal that needs to be demonised. If you want a slice of pizza or the occasional bacon roll, then fine. Likewise, there are no ‘superfoods’ or magic bullets, that can negate an overall unbalanced diet. But I want patients, and you, to explore the other options.
My message is about adopting a way of eating that prioritises vegetables, fruits, wholegrains – and yes, hunks of wholegrain bread can be included in this – fish, nuts and olive oils. Many patients are surprised to learn that full-fat dairy milk and yogurt are encouraged, and for most people eating eggs and shellfish too. Both foods, once considered ‘high cholesterol’ are in fact absolutely fine.
But these days I avoid whole aisles in the supermarket: the sugary breakfast cereals and snacks.
So, just what does a heart-healthy diet look like? Well, I’ve put together an eight-point guide. It’s all practical and achievable, even if you don’t manage everything all at once or every day. And, with the help of a team of recipe experts, we’ve come up with 21 simple, yet irresistible recipes that I hope will inspire you. Over the page, you’ll find delicious breakfasts, quick and easy lunches, and even family dinners that should make building a better diet not only easy, but a pleasure.
But first, read on to find out how you can start eating to beat heart disease today…
1) When it comes to veg, the more the better
Fruit and vegetables provide fibre, vitamins and antioxidants that may benefit heart health directly. They also crowd out the space on your plate that might otherwise be taken up with sugary fatty food.
A 2017 review published in the International Journal Of Epidemiology, analysed 95 studies looking at the effects of fruit and vegetable intake, and found that at around ten servings a day, risk of cardiovascular disease was lowered by 28 per cent. Don’t be daunted if that sounds a bit unachievable. The good news is that any increase is worthwhile – an analysis in 2014 found that for every additional serving of fruit and vegetables a day consumed there was an average four per cent reduction in risk of death from cardiovascular disease.
A good initial goal is to aim for five-a-day – the UK recommendation – and to work up from there if you can (a portion is 80g). It doesn’t take much to throw a handful of chopped red pepper into an omelette or some berries into porridge for breakfast.
Prioritise vegetables over fruit, as fruit is bred to be very sweet these days (up to three pieces of fresh fruit a day is fine but ideally not more). It’s also best to avoid juices and smoothies – consider how difficult it would be to sit and eat a plate of six oranges, but how easy it is to drink these down when they’ve been juiced.
2) Say yes to the right kind of carbs
Carbohydrates come in several forms including sugars, starches and fibre. Processed starchy and sugary foods like cakes, biscuits, full sugar soft drinks, white bread and mashed potato, aren’t good for heart health. They are very quickly digested, releasing sugar into your blood stream like a rocket.
Studies have shown that these spikes raise both diabetes and heart disease risk.
Closer-to-nature ‘whole’ carbs like pulses, unrefined grains and whole fruits and vegetables, provide heart-healthy options. Extra effort is required to digest these fibrous foods, which means they release sugar into your system more slowly. In fact, fibre, an indigestible form of carbohydrate, is a rising star when it comes to heart health.
Last month a huge World Health Organisation-commissioned study carried out over 40 years reported that people who consume the most fibre in their diet are 15 to 30 per cent less likely to die from any cause, including heart disease, compared with those who eat the least fibre. About 25 to 30 grams of fibre a day is the ideal intake – you’d achieve this by eating five portions of fruit and veg, two slices of wholemeal bread, half a can of baked beans and a handful of nuts.
As an easy guide, look at the ‘per 100g’ column on your food label and read off the figures for fibre and carbohydrates. If it’s a good choice, for every five to ten grams of carbohydrate there is at least one gram of fibre.
3) Eat as much fish as meat
Eating too much red meat isn’t good for the heart. Recent evidence suggests it’s a substance called carnitine in red meat that’s at issue – some types of gut bacteria break this down into a chemical called trimethylene N-oxide (TMAO), which increases blood clotting.
Processed red meats like ham, bacon, salami and hotdogs are the worst. It’s likely that the high levels of salt, preservatives and saturated fat found in these products add to the problem.
My rule of thumb is to have meat only a couple of times a week and to match this with two to three servings of fish or shellfish, including some oily fish, such as sardines, salmon, mackerel or tuna. Oily fish provides the healthy omega-3 fats that help blood flow through arteries better.
When you do eat meat try to make sure it’s lean and fresh.
On days when you don’t eat meat or fish add protein to your diet with healthy pulses, or consider an alternative like tofu or Quorn.
4) A spoonful of oil is the good medicine
The story on saturated fat – in butter, cheese, pastries, and red meat – is more nuanced than it used to be as new research has emerged. A diet rich in saturated fats can drive up total cholesterol as well as ‘bad’ LDL cholesterol and it does increase your risk of heart disease.
But if you cut it out and replace it with highly processed carbohydrates, you will do little to reduce your risk.
Replacing saturated fat with unsaturated fats such as vegetable oils or high-fibre carbohydrates is the best way to improve your heart health.
The two oils I recommend more any other are olive oil and rapeseed oil. Both provide heart healthy monounsaturated fats that help to improve the ratio of ‘good’ HDL to ‘bad’ LDL cholesterol in the blood.
It’s a good idea to consume about two tablespoons of either oil a day. Drizzle it on food, use in dressings, or for stir fries or roasting. Nuts are sources of good fat, but also fibre, protein, vitamins and minerals. Nuts also have the effect of making your LDL cholesterol a little less harmful.
5) Keep an eye on salt intake
Average salt intake in the UK is about 8.1g per day, down from over 9g a decade ago. This progress is largely due to the reformulation of products by the food industry – including lower amounts of salt in food like bread, sauces and ready meals. But progress is stalling and we are still way off the recommended 6mg-a-day target.
Cutting intake is really important for most of us to prevent or minimise rises in blood pressure as we get older.
Not many people realise that the more often you eat salt, the less your tongue can taste it.
The opposite is also true – cut it out for a few weeks and you will notice the difference.
Cooking food from scratch is the best way to keep intake down.
6) No need to avoid eggs… and full-fat milk is ok
Eating up to two eggs a day is fine in a heart-healthy diet, and dairy products rich in calcium and potassium seem good for the heart in moderation.
Research in medical journal The Lancet in 2018 examined data from more than 130,000 people across 21 countries and found that participants who ate two or more daily servings of milk or yogurt – including full-fat versions – had a 22 per cent lower risk of heart disease, 34 per cent lower risk of stroke, and 23 per cent lower risk of dying from cardiovascular disease.
Love your cheese? A serving should be matchbox-sized.
7) Be more savvy with pudding
Greece and Turkey have their baklava and the Italians their gelato – so how do the people of these nations maintain their historically good heart health rates?
In a traditional Mediterranean diet, sugar isn’t drip-fed through drinks, biscuits and processed foods – it’s more likely to be eaten occasionally at the end of a meal, when the rise in blood sugar is going to be slowed by the other food you have eaten.
If you eat unprocessed, low-sugar, whole foods most of the day, a small dessert after a meal won’t hurt your heart.
8) and finally… what about wine?
A review of alcohol risks published in September 2018 confirmed a reduced risk of angina and heart attacks in people enjoying one drink a day.
Unfortunately, they also found higher risks for hypertension, strokes, arrhythmias, cancer and infections at any level of alcohol.
They concluded that consuming NO alcoholic drinks daily ‘minimises the overall risk to health’.
If you do drink, as I do, stick to the guidelines but choose the tipple you like best – there’s no evidence that one type, like red wine, is any better for the heart than any other.